The American Lung Association reports tobacco use is still a leading cause of preventable illness and death in most states, including several in the Midwest, even though adult smoking rates are declining.
In its 2024 State of Tobacco Control report, the association gives mostly “F” grades to Iowa, Kansas, Missouri and Nebraska, for not doing enough to curb cigarette smoking and the use of flavored tobacco products like chewing tobacco, snuff and some kinds of cigars.
“It is unacceptable that after decades of research and proven tobacco control efforts, tobacco use is still the leading cause of preventable death and disease in the U.S. Tobacco use is responsible for 480,000 deaths each year,” said Harold Wimmer, the American Lung Association's president and CEO.
Data from the Centers for Disease Control and Prevention shows a steady decline in adult smoking rates in the region, but tobacco use still kills thousands each year.
While cigarette smoking rates among high school students are also down in the region, the use of other tobacco products is not, according to the report.
High school tobacco product use:
- Nebraska 19%
- Iowa 23%
- Missouri 25%
- Kansas 26%
Source: CDC (2019)
The ALA says there are pending laws that could be effective in reducing the use of flavored tobacco products, which can be attractive to both adults and teens.
In 2022, the Food and Drug Administration proposed a ban on adding flavor to cigars. It also proposed ending menthol in cigarettes. Menthol, which can cool the throat and reduce the harshness of smoke, has been shown to make it both easier to start smoking and harder to quit, according to the ALA. The organization is calling on the Biden Administration to approve the proposals.
The Campaign for Tobacco Free-Kids has joined the ALA and other groups in calling for bans on both menthol and other flavors.
“Menthol cigarettes are disproportionately smoked by the Black community,” said Yolonda Richardson, president of the Campaign for Tobacco Free-Kids. “Therefore you're seeing a disproportionate health impact, because that is the one flavored cigarette product that remains on the market.”
Richardson said flavored tobacco products have no place on store shelves.
“Flavoring helps tobacco products be consumed more easily,” she said. “We've always called on those kinds of flavorings to be removed from tobacco products, making them less attractive to consumers.”
What about vaping?
The State of Tobacco report does not touch on tobacco-free products like electronic cigarettes, but Richardson said her organization is calling for the federal government to regulate vaping products all the same.
“The good news is that we were able to finally create enough public alarm around e-cigarettes,” she said. “We are starting to see those rates decline. But 2 million kids still use e-cigarettes.”
Richardson said e-cigarette makers promote the fact that vaping does not bring carcinogens and other harmful toxins into the lungs, but e-cigarettes contain nicotine, which is highly addictive.
“The jury is still out about how harmful these products are in general,” she said. “But we know that nicotine impacts brain development and that means cognitive function declines for these young people.”
The FDA started authorizing tobacco-flavored e-cigarette products and devices in 2022, more than a decade after they began to appear on store shelves without regulatory approval.
“Take them off the market,” Richardson said. “They shouldn't be there anyway.”
This story comes from the Midwest Newsroom, an investigative journalism collaboration including IPR, KCUR 89.3, Nebraska Public Media News, St. Louis Public Radio and NPR.
